The Promise of Adolescence
Realizing Opportunity for All Youth

INTRODUCTION

Over the past several decades, research has fundamentally changed our understanding of how adolescents—young people ages 10 to 25—develop, grow, and learn. Changes in brain structure and function (such as the strengthening of connections within and between brain regions and the pruning away of unused connections) that occur during adolescence affords young people a remarkable capacity to learn, adapt to changes, and explore their own creativity. Adolescent brains are specially tailored to meet the needs of this stage of life, allowing them to explore new environments and build new relationships with the world and people around them.

But what does our new understanding mean for society? How can we create the kinds of settings and supports that allow adolescents to thrive and make meaningful contributions to the world around them?

 

A positive pathway into a thriving adulthood is not forged by adolescents alone. Instead, it requires alignment between the strengths of adolescents, like their increased independence, flexible problem solving skills, and openness to new experiences, with resources available in their environments.

 

There is an urgent need to reimagine and redesign the systems and settings that adolescents most frequently encounter, including the education, health, justice, and child welfare systems. By embracing a collective responsibility to build systems that account for the new knowledge we have acquired, we can ensure that millions of young people flourish and can impact society for the better.

Read Chapter 1.

Who Are Today’s Adolescents?

2010

10-24-year-olds in 2010 U.S. Census

2017

There were approximately 73.5 million adolescents ages 10 to 25 in 2017, representing 22.6 percent of the U.S. population.

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2020

The adolescent population is expected to become majority-minority by 2020.

image of teens jumping and arrow moving upwards

Adolescent Development

Adolescence begins with the onset of puberty (around age 10) and ends during the mid-20s (age 25). Unique changes in brain structure and function, make adolescence an exciting and important time for growth, learning, and discovery. Learn more about adolescent development in Chapter 2.


Puberty occurs over an extended period of a young person’s life during which developmental changes result in the maturation of primary and secondary sex characteristics and the acquisition of reproductive maturity. Socially, pubertal maturation and its accompanying physical changes also affect how adolescents perceive themselves and how they are treated by others.

As connections within and between brain regions become stronger and more efficient, and unused connections are pruned away, adolescent brains exhibit plasticity. This means adolescents’ brains are adaptive; they become more specialized in response to environmental demands. The onset of puberty also brings about changes in the limbic region of the brain, resulting in greater sensitivity to rewards, threats, novelty, and peers. In contrast, it takes longer for the cortical region, which is implicated in cognitive control and self-regulation, to develop.

The temporal discrepancy in the specialization of and connections between brain regions makes the adolescent brain specially tailored to this stage of life. The heightened sensitivity to rewards, willingness to take risks, and the salience of social status—propensities that are critical for exploring new environments and building nonfamilial relationships—help adolescents build the cognitive, social, and emotional skills necessary for productivity in adulthood.

The increased cognitive abilities gained during adolescence create the capacity for other aspects of psychosocial development, such as developing identity and capacity for self-direction. An adolescent’s identity is an emerging reflection of his or her values, beliefs, and aspirations, and it can be constructed and reconstructed over time and experience. Adolescence is also marked by a growing capacity for self-direction. Over the course of adolescence, youth gain the cognitive skills needed to reflect on complex questions about their role in the world. This enables them to question the legitimacy and fairness of everyday experiences and of social institutions.

The Interplay of Environment and Biology

Contrary to the common understanding that a person’s genes are set in stone, con­temporary studies show that genes and environment interact: The way heredity is expressed in behavior depends significantly on influences in a person’s environment. And the trajectory of an individual’s life may be changed, neg­atively or positively, at each life stage. Protective factors in the environment—such as supportive relationships with family and caretakers and access to resources—support positive trajectories, while harmful experiences (such as toxic stress and housing insecurity) may lead to at-risk or poor trajectories (Figure 1).

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· Figure 1: Epigenetic life-course perspective: preconception to older adult. Adapted from Haflon et al., 2018.

Investments in programs and interventions that capitalize on the brain’s capacity to change during adolescence can promote beneficial shifts in young people’s life trajectories, both for youth who may have faced adverse experiences earlier in life, and for those who are facing challenges now.

To learn more about how the environment can get under the skin, see Chapter 3.

Inequity in Adolescence

Disparities in family and neighborhood resources and supports, biased and discriminatory interactions with important social systems, and resulting inequalities in opportunity and access severely curtail the promise of adolescence for many youth. For example, some young people have access to high-quality education and supportive social networks while others have neither. Some young people face discrimination while others do not. These differences can significantly hinder an adolescent’s ability to thrive. Our collective prosperity depends on equal opportunity for all young people.



Graphs: Disparities in Adolescence



Percentage of Students Proficient in Math, by Race/Ethnicity, 2017

Source: Data from the National Assessment of Educational Progress, National Center for Education Statistics



Percentage of Students Proficient in Math, by Gender Identity, Income, and Nativity, 2017

Source: Data from the National Assessment of Educational Progress, National Center for Education Statistics



Share of Youth In Group Homes and Aging out of Foster Care by Race/Ethnicity, 2016

Source: U.S. Department of Health and Human Services, Administration for Children and Families

Juvenile Detention rate per 1,000, 2015

Source: U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention



Measures of Adolescent Health, by Race/Ethnicity and Gender Identity, 2017

Source: Data from National Center for Health Statistics





Disparities in adolescent outcomes are not immutable. They are responsive to changes in underlying conditions, and adolescents themselves show resilience and demonstrate strengths and assets that may be utilized to overcome inequities. An effective strategy to reduce inequities needs to address the main sources of disparities. Some promising policies and programs that tackle these disparities in opportunity include:

Policies and programs to reduce disparities in income, wealth, and neighborhood resources, such as the Supplemental Nutrition Assistance Program and the Earned Income Tax Credit.


Trauma-informed approaches preparing adults serving youth to address differential exposure to violence and trauma, such as the Cognitive Behavioral Intervention for Trauma in Schools and the Sanctuary Model.


Emerging tools to erase or counteract bias in decision making, such as using predictive analytics for investigations and placement decisions in the child welfare system.


For more on inequity in adolescence, see Chapter 4.

Principles for Policy & Practice

In making its recommendations for the education, health, child welfare, and justice systems, the committee identified six cross-cutting principles for policy and practice. These principles are informed by the neurobiological and socio-behavioral science of adolescence and an understanding of the troubling and increasing disparities in opportunity among youth. Click on each principle to learn more, and see Chapter 5 for more information.

Education

The U.S. education system was largely designed for an earlier era. Schools must broaden their missions to meet the needs of modern adolescents. This will require schools to become more culturally competent (meaning understanding differences in background and building on adolescents’ varying strengths), to emphasize non-academic skill building (like developing strong interpersonal skills), and to help young people navigate numerous educational and career opportunities. To learn more about adolescents’ experiences in the education system, see Chapter 6.

Recommendations

The committee’s recommendations highlight six key areas to implement such change. Taken together, they form a blueprint for a developmentally-informed secondary education system.

Blueprint for a Developmentally-Informed Secondary Education System for Adolescents

  1. All states should take steps to eliminate resource disparities across districts and schools by exploring methods or formulas for financing education to augment or replace municipal tax bases.
  2. In coordination with states and localities, the federal government should develop “NextStep,” a program targeting underprivileged adolescents to promote both their academic and non-academic development.
  1. Recognizing the enormous heterogeneity in the academic levels and needs of adolescents, school districts should be funded to improve their capacity to adapt to individual students’ needs, including pace of learning and need to make up work.
  2. School districts should facilitate diverse pathways and postsecondary plans for adolescents, including for those students interested in career-oriented or vocational education and training as well as those who are college-bound, and ensure that students have the skills and access to coursework necessary for the option to switch between the two as their interests may evolve.
  3. School districts should design flexible schedules for course offerings during the academic year and the summer to enable youth to easily make up classes, recover lost credits, and advance in their course work, especially for youth who are over-age and under-credited. In addition, school personnel should help youth and families create specific plans to recover lost credits, to advance in their course work, and to pursue postsecondary job and career opportunities.
  4. Schools should provide flexible and diverse opportunities for students to develop interests, talents, and dispositions to foster their general wellbeing and facilitate their civic engagement.
  5. States and localities should provide funding to allow schools to hire sufficient career, vocational, and college counselors who are knowledgeable about the local job markets in order to prepare youth for 21st century jobs and identify internships and apprenticeships to facilitate the training youth need to transition to the job market.
  6. Local businesses and school districts should create robust relationships and specific programmatic linkages to ensure that school curricula enable youth to learn the skills and information needed to prepare them for meaningful jobs and careers in the local economy.
  7. Local businesses, local colleges, and school districts should create specific internships and apprenticeship training programs to prepare youth for, and provide credentials for, meaningful jobs and careers.
  1. Schools should create significant opportunities for youth to develop non-academic skills, including project-based learning, socio-emotional learning, and practices encouraging reflection on intellectual growth and personal identity.
  2. Schools should teach adolescents specifically about brain development so that they understand its connections to their own health and well-being.
  3. Schools should provide opportunities to youth both within classrooms and within the larger school context to regularly make impactful decisions in order to develop both decision-making skills and efficacy for civic engagement.
  4. The U.S. Department of Education should create guidelines for, and school districts should create, curricula to ensure mastery of practical life skills for youth upon graduation, either through specific courses or integration into existing courses. Practical knowledge includes finance management, budgeting and banking; obtaining and managing insurance (e.g., health, auto); housing (renting, leasing, mortgages, contracts); and transportation (e.g., drivers licenses, identification and processes for using public transportation such as trains, buses, and air travel).
  5. To foster civic engagement and decision-making and to empower youth to effect change in their communities, school districts and local governments should provide youth with opportunities to participate in research designed to improve the agencies that are directed to serve them (e.g., by designing and identifying appropriate research questions, analyzing appropriate data, and drawing recommendations and conclusions).
  1. Given the importance of sleep for adolescents, researchers and policy makers should prioritize identifying ways to mitigate the potential challenges of later school start-times and fully consider the benefits of sleep for adolescents. School staff should consider the value of sleep as they plan the school day and design homework and assignments.
  2. School districts should enact policies and practices that promote supportive school climates and ensure safety for all students.
  3. States and localities should provide funding for, and direct schools to provide, increased access to mental health services for students.
  4. School districts, in coordination with their local communities, should ensure that adolescents have the time and opportunity to engage in sufficient health-promoting physical activity each day and that healthy food options are available.
  1. State and federal agencies, school districts, and schools should require that teachers, counselors, administrators, and staff engage in regular training on implicit bias and cultural sensitivity, generally and as they relate to specific populations within the school
  2. Schools should recruit and retain a diverse workforce to mirror the diversity of their student bodies College and university schools of education and other teacher training programs should require coursework that assures mastery of adolescent development and culturally inclusive pedagogy and implicit bias in their training of teachers
  3. School districts and schools should implement curricula that are culturally inclusive and affirm the value of the diverse ethnic and cultural backgrounds represented among students, both in content and learning styles
  4. Schools and school districts should create curricular opportunities for culturally relevant content and exposure to perspectives of non-dominant groups
  5. Schools and districts should establish and utilize disciplinary policies and practices that are developmentally appropriate and ensure that disciplinary measures are applied equitably and fairly
  6. School leaders should assess and monitor their disciplinary practices to assure that they are free of biases by race, gender, socioeconomic status, or ability status
  7. School districts and schools should implement equity-driven principles of conflict intervention
  1. Schools should support adolescents and families by serving as a coordinator of institutional services, such as providing assistance in identifying internships, apprenticeships, mentoring, and training for career and vocational transitions, along with navigating the college admissions process.
  2. School districts should assist families in navigating the education sector to identify opportunities and resources to meet the specific educational needs of their adolescents.

Health

Access to appropriate health care services is important for adolescents, both to ensure their well-being today, as they experience the bumps and stresses of adolescent life, and to ensure their well-being for a lifetime by addressing habits that affect their long-term health. The U.S. health care system can better support adolescents by helping them navigate the health care system independently and by providing services that are culturally-informed and attentive to their needs. Significant work is needed to develop a health care workforce that can help adolescents feel safe and welcomed. To learn more about adolescents’ experiences in the health system and the challenges they face, see Chapter 7.

Recommendations

The committee’s recommendations draw on research to identify more effective health policies, programs, and prac­tices with five key aims.

Blueprint for Creating an Adolescent-Friendly Health System

  1. Federal and state policymakers should make changes within Medicaid to increase access for adolescents, including expanding Medicaid in states that have not yet done so, increasing Medicaid reimbursement rates for pediatric health services to be on par with those for Medicare, allowing equitable reimbursement for comprehensive health services, and eliminating the five-year-eligibility restriction on the use of Medicaid for documented immigrant adolescents.
  2. Federal, state, and local agencies, in partnership with philanthropic foundations and the private sector, should ensure adequate financial support for comprehensive, high-quality, culturally informed, and integrated physical and behavioral health services for adolescents.
  3. To finance comprehensive, adolescent-friendly health services, federal and state policy makers should adapt eligibility requirements to allow blending of existing funding mechanisms across sectors at the local level.
  1. State and federal agencies, health systems, and health care providers should collaborate to provide comprehensive, integrated, and coordinated care for adolescents, linking physical and behavioral health providers as well as connecting other vital support services to the health sector.
  2. With help from federal agencies and designated funding, health care providers, public and private health organizations, and community agencies should work to develop or enhance coordinated, linked, and interdisciplinary adolescent health services. This includes funding community outreach efforts to attract and retain adolescents and their families in the health care system.
  3. To better understand effective methods for delivering coordinated care, federal research agencies and other research funders should encourage and replicate pilot programs and interventions that aim to decrease fragmentation and alleviate the complicated maze of services for adolescents and their families.
  4. Health care providers and health organizations should implement policies and practices that support adolescents’ emerging sense of agency and independence, such as ensuring that all adolescents receive confidential health care for sensitive services as appropriate, such as empowering youth to meaningfully participate in their health care.
  5. Health care providers, public and private health organizations, health insurers, and state governments should ensure that all adolescents receive confidential care for sensitive services. Policies and ethical guidelines should enable adolescents who are minors to give their own consent for health services and to receive those services on a confidential basis when necessary to protect their health, and states should enact stronger regulations that ensure confidential access to sensitive services.
  1. Federal agencies and behavioral health education institutions should work together to grow the behavioral health workforce available to adolescents, particularly those in underserved areas by expanding HRSA’s Behavioral Health Workforce Education and Training program and expanding the National Health Service Corps’ scholarship program to include mental and behavioral health providers.
  2. Federal, state, and local policymakers should develop and implement behavioral health programs for prevention, screening, and treatment that better meet the needs of all adolescents, with particular attention to vulnerable groups. Adolescents should actively participate in program development and implementation.
  1. Regulatory bodies for health professions in which an appreciable number of providers offer care to adolescents—such as the American College of Obstetrics and Gynecology, American Academy of Family Medicine, American Academy of Pediatrics, American Academy of Physician Assistants, and state boards of nursing and social work—should include a minimum set of competencies in adolescent health care and development into their licensing, certification, and accreditation requirements, and all pediatricians and primary care providers should have a minimum level of competency in adolescent medicine.
  2. Public agencies and private organizations should work together to expand the number of training sites for board-certified adolescent medicine fellowships across multiple academic training centers.
  3. HRSA, medical and nursing schools, and other key stakeholders should work together to create new pathways for medical students and other health professionals to become adolescent health specialists.
  1. The Federal Interagency Forum on Child and Family Statistics should work with federal agencies and, when possible, states to organize and disseminate data on the health of and health services for adolescents, including developmental and behavioral health.
  2. To improve the health of adolescents, data must be used to assess whether existing programs and services are working. State and local health agencies should work with community-level adolescent service providers to identify opportunities for improvement in their programs.
  3. Federal health agencies and private foundations should prepare a research agenda for improving adolescent health services that includes assessing existing service models, developing new models for providing adolescent-friendly health services, piloting projects to develop and test innovative approaches for incorporating neurodevelopmental and socio-behavioral sciences in the delivery of healthcare to adolescents, and evaluating the effectiveness of collaborations.

Child Welfare

Relative to young children, adolescents have advanced decision-making skills and can more effectively seek solutions that are right for them. Therefore, adolescents in the child welfare system need services and supports that differ from young children and that allow them to be partners in decisions that affect their housing, health, mental health, and education. See Chapter 8 to learn more about how the child welfare system can be reformed to meet the needs of adolescents.

Blueprint for a Developmentally-Informed Child Welfare System for Adolescents

  1. State and local departments of child welfare should implement policies and practices that ensure that families of color have access to the same levels of in-home preventative services as other at-risk families. 
  2. State and local departments of child welfare should establish guidelines and protocols regarding appropriate levels of surveillance in communities to improve the overall efficiency and benefit of surveillance systems, a practice also expected to reduce disparities. Responsible agencies should actively monitor implementation of these guidelines.
  1. All states should adopt the existing federal option to provide extended care to youth until age 21 and Chafee services to age 23 and provide comprehensive aftercare support to youth as they transition out of the child welfare system.
  2. All states should ensure that child welfare-involved youth are eligible for education and training vouchers until they reach age 26 and should facilitate and support youths’ application process.
  3. All states should ensure that youth who have experienced foster care are eligible for Medicaid until age 26.
  1. State and local departments of child welfare should implement policies and practices that incorporate a developmental approach to service provision and case management for adolescents with child welfare system involvement, prioritizing family connections and supportive adults, and taking maximum advantage of adolescents’ increasing cognitive and social capacities.
  2. State and local departments of child welfare should adjust the type and structure of services and the level of adolescent involvement in decision-making related to their housing, education, and services to best align with adolescents’ developmental capabilities and needs.
  3. Recognizing the growing capacity of adolescents for self-direction, case managers and courts should ensure that adolescents have the opportunity to fully participate in developing and implementing their service and transition plans, while maintaining critical ties with caring adults. To this end, adolescents should be viewed as respected partners in decision-making regarding their placements, education, and support services.
  1. The federal government, state and local child welfare agencies, and philanthropic institutions should fund research on service characteristics and outcomes for the full range of adolescents in the child welfare system in order to better design and evaluate services specifically for adolescents, depending upon their age, child welfare system history, and placement situation.
  2. Individual and program successes identified through this research should be scaled to system-level change for adolescents in the child welfare system.
  1. Child welfare, juvenile justice, education, and health agencies should collaborate to create an integrated data system that links information to track, evaluate, and provide an effective and integrated set of services to adolescents across these systems.
  2. State and local child welfare and education agencies should collaborate to minimize educational disruptions for child welfare-involved youth. This includes insuring proper transfer of credits, appropriate school placement and services, and school transportation services when continuation in the original school is desired.
  3. An arrest, court petition, delinquency finding or other involvement in the juvenile justice system should not disqualify an otherwise eligible child from remaining in or re-entering foster care for the full period of eligibility.

Justice

Because adolescent brains are still developing, the juvenile and criminal justice systems need to enact policies and practices that reflect our understanding of brain development and adolescents’ potential responsiveness to preventive interventions.

Areas of opportunity for reform within the juvenile justice system include increased family engagement and greater attention to procedural fairness, including interactions with police, legal representation for youth, and reduced use of juvenile fines and fees.

Similar reform efforts recognizing the developmental needs of older adolescents and young adults are emerging within the criminal justice system, including reducing automatic transfers of juveniles to criminal courts based only on the charged offense, and creating developmentally informed correctional programs for young offenders. These efforts should be guided by the science of adolescent development.

For more on adolescents’ needs in the justice system, see Chapter 9.

Blueprint for a Developmentally Appropriate Justice System

  1. Congress should ensure proper implementation of the Juvenile Justice and Delinquency Prevention Act (JJDPA), including oversight of state efforts to monitor and reduce racial and ethnic disparities with an increased focus on research and data collection
  2. The Office of Juvenile Justice and Delinquency Prevention (OJJDP), in accordance with requirements laid out in the JJDPA, should require at a minimum that all states furnish specific, rigorous metrics on the race and ethnicity of youth involved in the justice system
  3. School systems should leverage available federal, state, and local funding to implement evidence-based programs to improve social and structural conditions to reduce racial disparities and student referrals to the justice system.
  4. Law enforcement officials and other institutions and community organizations should undertake prevention programming designed to reduce justice-system involvement by disadvantaged groups, based on social and structural inequities differentially experienced by those groups.
  1. Juvenile facilities should amend policies that curtail visitation rights as punishment, and states and localities should implement policies and practices to assist families in overcoming barriers to prison visitation so that youth can remain connected to parents, caregivers, and other relatives.
  2. Probationary programs should connect parents and caregivers with community and educational resources that can teach them how to help their child succeed and avoid future interactions with the justice system.
  3. State legislatures and courts should ensure that justice-involved youth are provided with competent counsel throughout the legal process.
  4. State legislatures and courts should ensure that adolescents under the age of 15 are not allowed to waive the right to an attorney or the right to remain silent without prior consultation with an attorney.
  1. Congress and state legislatures should enact legislation to eliminate the use of sex offender registries for non-violent juveniles.
  2. Given the robust evidence of the harmful effects of solitary confinement, the federal government or philanthropic organizations should fund research on effective alternatives to solitary confinement so that detention facilities will be able to scale back or eliminate the use of this practice as soon as practicable.
  1. Legislatures should restore judicial discretion in decision-making about transferring juveniles to or from criminal courts.
  2. Prosecutors and courts should be guided by the principles of proportionality and individualization with consideration given to the maturity, needs, and circumstances of the individual offender when making transfer decisions.
  3. Judges sentencing juveniles in criminal courts should place these youth in juvenile correctional settings rather than adult correctional facilities. These youth should be entitled to all of the services they would have received if they had received a juvenile disposition and, upon turning 18, should be entitled to placement and services available to young adult offenders. Courts should conduct formal review of youths’ criminal sentences on an individualized basis to determine whether the sentences should be adjusted in light of their mitigated culpability and prospects for successful adjustment in the community.
  1. Correctional programming for adolescents and young adults in the criminal justice system should promote accountability and reduce re-offending through developmentally appropriate services in both correctional facilities and residential and community settings, including mental health, substance abuse, education, and social services.
  2. Researchers, in partnership with practitioners, should urgently examine and evaluate effective alternatives to solitary confinement that promote the healthy development of individual youth and protect the safety of all in the facility.
  3. State and local educational agencies should work in partnership with their justice system counterparts to ensure that rigorous and relevant curricula for adolescents are delivered in residential facilities and that these curricula are aligned with career and technical education standards and meet the needs of all youth, including those with disabilities and English learners.

What Parents Need to Know

Parents, families, and other caregivers play an essential role in supporting the wellbeing of their developing adolescents. Supportive relationships with parents and caregivers are the foundation of healthy development for adolescents, just as they are for young children. While the role of parents certainly changes compared to early in life, their significance does not.

While there is no prescription for being the “perfect parent” to an adolescent, decades of research suggest a few practices that are consistently associated with positive youth outcomes across contexts.

Being supportive. Adolescents need to feel valued, loved, and safe, just as they did in early childhood. Being attuned to young people’s emotional needs and knowing what is going on in their lives has important benefits for development throughout adolescence.

Being firm. This involves setting boundaries and expectations around appropriate behavior, and consistently communicating these expectations to adolescents. Being firm while also showing support is particularly important. To learn more about the role of parents in adolescents’ lives, see Chapter 5.

Youth Voices

Adolescents have the power to shape the course of their own lives, as well as the well-being of their communities and society at large. Environment and experience critically sculpt the developmental process of adolescence, and youth themselves are shaping these experiences and environments.

Throughout the study process, the committee engaged with a diverse group of adolescents to learn how they perceive their communities, families, and themselves. Youth from across the country were engaged to share their knowledge, experiences, and insights with the committee.

Youth Voice Panel Video

To learn more about the committee’s efforts to engage youth, see the MyVoice commissioned paper and Appendix B. For youth perspectives on specific topics, see:

Conclusion

Adolescence is a period of great opportunity to promote learning and discovery and to address the harmful effects of past negative experiences. Our society has a collective responsibility to build systems and enact policies that help adolescents thrive and take advantage of the great promise of this stage of life. These systems should account for the new knowledge we have acquired through research. By embracing this collective responsibility, we can ensure that millions of young people flourish and impact society for the better.

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The Promise of Adolescence Realizing Opportunity for All Youth (2019)

Sponsors


Funders for Adolescent Science Translation, including:
The Annie E. Casey Foundation
The Bezos Family Foundation
The Chan Zuckerberg Initiative
The Ford Foundation
The Conrad N. Hilton Foundation
The Raikes Foundation
The Robert Wood Johnson Foundation
The National Public Education Support Fund